What Is Dystocia?

Dystocia generally refers to certain conditions that occur during childbirth, such as problems with the fetus itself, or mother's pelvic stenosis, abnormal uterine or vaginal structure, weak or abnormal uterine contractions, etc., which cause fetal delivery difficulties and require assisted delivery or end of cesarean The situation of childbirth. The clinical manifestation is that the delivery process is slow or even stopped. The successful delivery of the fetus via vagina depends on three factors: productivity, birth canal and fetus. If one or more of these factors is abnormal, it can cause dystocia.

Basic Information

English name

dystocia

Visiting department

Obstetrics and Gynecology

Common causes

Fertility, birth canal, fetus, psychological factors

Common symptoms

During vaginal delivery, the labor process does not progress smoothly and the fetus cannot be delivered smoothly

Contagious

no

Causes of dystocia

Productivity

The force that the fetus and its pregnancy appendages push out of the uterus is called productive force, which is the force of uterine contraction (uterine contraction) that we often talk about. The contraction of abdominal wall and diaphragm muscles (the power of abdominal pressure) and contraction of the levator ani muscle after uterine opening is combined to form the productivity, of which the uterine contraction is the most important factor. Insufficient productivity can result in difficult labor.

2. birth canal

The birth canal is the passage through which the fetus is delivered. It is divided into the bone birth canal and soft birth canal. The "pelvis" we usually refer to is the bone birth canal. The size and shape of the pelvis are closely related to childbirth. The main cause of dystocia is that the pelvis is not commensurate with the fetus due to an oversized fetus or abnormal fetal head position, which is medically referred to as "head and pelvis disproportion", resulting in dystocia.

3.fetus

The fetus is another key factor in determining whether it is difficult to give birth, which depends on the size of the fetus, the fetal position and the presence of deformities. Fetuses weighing more than 4000 grams are called giants. In the process of delivery, when the fetus is too large, the fetal head may be difficult to deliver because the fetal head and pelvis are disproportionate, although the pelvic measurement is normal. Some fetuses are not very heavy, but abnormal fetal head position can also cause dystocia. Such cases are often seen clinically, and the fetal head cannot be lowered into the pelvis near the due date or after delivery, but it is in a floating fetal head state. In this case, we must be alert to the mismatch between the fetal head and the pelvis, which may cause labor difficulties.

4. Psychology

We must realize that in addition to fertility, birth canal, and fetus, the factors that affect childbirth are also psychological and psychological factors of expectant mothers. Most of the first childbirths are a long process of labor pain. Severe pain, unfamiliar and lonely environment in the delivery room will increase the fear and anxiety of expectant mothers, and make the birth process abnormal.

Clinical manifestations of dystocia

During vaginal delivery, the labor process does not progress smoothly and the fetus cannot be delivered smoothly.

Dystocia inspection

Medical history

Ask the pregnant woman if she has a history of rickets, polio, spinal and hip tuberculosis, and trauma. If you are a pregnant woman, you should know if you have a previous history of dystocia and its causes, and if there is a birth injury in the newborn.

2. General inspection

Pay attention to the general development situation. Those who have short stature and abnormal fetal position will not enter the pelvis and / or have an overhanging belly before giving birth, which indicates that the pelvis may be narrowed. The Marker's pelvis may tilt.

3. Pelvic measurement

Flat pelvic diameter <17cm should be suspected as a flat pelvis, those with diameters less than 1.5cm above normal are small pelvis, and those with sciatic tubercle diameters below 7cm are usually accompanied by mid-section stenosis, which should be further measured within the pelvis.

Difficult diagnosis

It is not difficult to diagnose based on symptoms and signs.

Dystocia treatment

First of all, the thoughts of pregnant women should be relieved, nervousness should be relieved, pregnant women should be encouraged to eat more, rest and sleep properly, maintain sufficient energy and empty the bladder. Depending on the cause of the dystocia, enhanced contractions, sedation, techniques or instruments can be used to assist the delivery, if necessary by caesarean section.